Engaging Patients in Diagnostic Error Reporting

项目总结/摘要 诊断错误对患者安全构成重大威胁。根据最近的医学研究所报告， 改善医疗诊断，大多数人可能会遇到至少一个诊断错误， 一生，有些是毁灭性的后果。尽管人们对诊断错误和政策的兴趣越来越大， 提高患者参与度的举措，患者的诊断错误经验未被充分利用， 改进.该提案的目标是开发和测试以患者为中心的电子诊断错误- 报告制度。具体目标是：1）确定患者和家属的经验， 诊断错误和关于以患者为中心的错误报告最佳实践的观点; 2）确定当前工作 患者报告诊断错误的系统障碍和促进因素;以及3）开发和测试电子， 以患者为中心的诊断错误报告系统，用于捕获和分类患者和家属报告的 诊断错误。在目标1中，将与受以下影响的患者及其家属进行深入访谈： 诊断错误。在目标2中，将与患者安全官员、安全和 法律的工作人员和临床医生确定从患者报告中学习的促进因素和障碍，包括如何 将其整合到现有的错误报告策略中。在目标3中，将根据 目标1中患者和家属的语言和个人经历，目标2中的发现和输入 关键利益相关者（例如，患者和患者安全和临床信息学方面的专家）。一个电子错误- 将使用分类法开发报告系统，为数据结构提供信息。为了完善电子 系统，迭代可用性测试将与经历过以下情况的患者和家庭成员进行 诊断错误最后，以病人为中心的电子报错系统将进行试点测试，以确定 它的可行性和可接受性与谁经历了诊断错误的患者。 这个K 01奖项将促进Traber Giardina博士的长期职业目标，成为一个独立的 卫生服务研究员。受保护的时间将使她在四个关键领域的培训和经验： 安全性、参与性研究方法、信息学和人为因素原则。培训将完成 通过教学课程，研讨会，会议和指导研究项目的组合。我 导师，Hardeep Singh，MD，MPH，一位经验丰富的导师和国际公认的诊断专家， 错误研究，和院长Sittig，博士，在应用临床信息学领域的国家公认的专家， 将监督训练。拟议的工作是一个实质性的偏离以前的研究， 通过将患者经验纳入诊断错误文献来提高患者安全性的领域， 开发以患者为中心的电子诊断错误报告系统， 报告诊断错误。

Project Summary/Abstract Diagnostic errors pose a significant threat to patient safety. According to the recent Institute of Medicine report, Improving Diagnosis in Health Care, most people will likely experience at least one diagnostic error in their lifetime, some with devastating consequences. Despite increased interest in diagnostic errors and policy initiatives to increase patient engagement, patient experiences of diagnostic error are underutilized as tools for improvement. The goal of this proposal is to develop and test an electronic patient-centered diagnostic error- reporting system. The specific aims are to: 1) Determine patients' and family members' experiences of diagnostic errors and views on patient-centered best practices for error reporting; 2) Identify current work system barriers and facilitators to patient reporting of diagnostic error; and 3) Develop and test an electronic, patient-centered, diagnostic error-reporting system to capture and classify patient- and family-reported diagnostic errors. In Aim 1, in-depth interviews will be conducted with patients and family members affected by diagnostic errors. In Aim 2, key informant interviews will be conducted with patient safety officers, safety and legal staff and clinicians to identify facilitators and barriers to learning from patient reports, including how to integrate it into existing error reporting strategies. In Aim 3, a taxonomy will be developed based on the language and personal experiences of patients and family members from Aim 1, findings from Aim 2 and input from key stakeholders (e.g., patients and experts in patient safety and clinical informatics). An electronic error- reporting system will be developed using the taxonomy to inform the data structure. To refine the electronic system, iterative usability testing will be conducted with patients and family members who have experienced diagnostic error. Finally, the patient-centered electronic error-reporting system will be pilot tested to determine its feasibility and acceptability with patients who have experienced a diagnostic error. This K01 award will facilitate Dr. Traber Giardina's long-term career goal to become an independent health services researcher. The protected time will allow her training and experience in four key areas: patient safety, participatory research methods, informatics and human factors principles. Training will be accomplished through a combination of didactic coursework, seminars, conferences and mentored research projects. My mentors, Hardeep Singh, MD, MPH, an experienced mentor and internationally recognized expert in diagnostic error research, and Dean Sittig, PhD, a nationally recognized expert in the field of applied clinical informatics, will supervise training. The proposed work represents a substantive departure from previous research in the area of improving patient safety by incorporating patient experiences into the diagnostic error literature and developing a patient-centered electronic diagnostic error-reporting system to capture and utilize patient reported diagnostic errors.